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Comments: <br /> Conflict of Interest is defined as the participation in any activity, recommended action, <br /> or decision from which the individual has or could have the potential to receive personal <br /> gain, whether it is direct or indirect. In accordance with this definition, do you have any <br /> legal or equitable interest i y business which could be construed as a conflict of <br /> interest? Yes No <br /> If yes,provide details on a separate piece of paper. <br /> �, i�laila�dt� <br /> Applicant Si ature Da�e— <br /> Questions may be directed to the City Administration Office at 218-568-5222. <br /> Return Completed Application to: City of Pequot Lakes <br /> City Administrator <br /> 4638 Main Street <br /> Pequot Lakes, MN 56472 <br /> E-mail: nmalecha a�pequotlakes-mn.� <br /> Website: www.pec�uotlakes-mn.�o_v <br /> OFFICE USE ONLY <br /> The Applicant is: New Applicant Applying for Reappointment <br /> Council Action: Not Appointed <br /> Appointed to: <br /> Date Appointed: <br /> Term Ezpires: <br /> S.Wdmm�stration\C�ty Clerk�Boards and Commissions�,SppLcation Process and Forms�FormsUlpphcahon Form for Boards and Commissions.doc <br /> Page 3 <br />